Implementing strategies for hepatitis B vaccination.

This study reviewed the effects of hepatitis B virus (HBV) vaccination programs on disease control and the need, if any, to introduce additional strategies taking into account the various risk factors of transmission. We performed a search conducted on vaccine administration, hepatitis B risk factors and the impact of HBV vaccination on prevention of disease, using the electronic database MEDLINE (1987 to 2008), EMBASE, OVID, Google (for Local websites and medical journals), Websites of Iranian universities and Iran medex in English and Persian language. We recommend in addition, to routinely practice the Extended Program of Immunization (EPI) schedules for infants as well as implementing HBV vaccination in selected adolescents at risk for HBV infection. Routine screening and immunization is mandatory in the following people: pregnant women and adults at risk for HBV infection including health-care workers, police, fire fighters, barbers, people with certain risk behaviors such as inmates of correctional facilities, injection-drug users and persons at risk for sexual transmission, as well as patients exposed to blood and blood products and those on chronic hemodialysis. Vaccine providers in areas with high rates of chronic HBV infection should assess infection screening by performing serologic tests in susceptible subjects to identify persons who require counseling and management. Also, additional studies are needed to determine the effectiveness of currently employed immunization strategies.